Application & Promissory Note

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1 Application & Promissory Note STOP Before you apply make sure you look into any federal education loans you may be eligible for. You should understand the benefits of federal loans, such as: No interest payments required during school for subsidized federal loans Low fixed interest rates Deferments Forbearances Loan forgiveness Various repayment plans (including income based) For information on federal loans visit The Application Process: 1. Apply for and have your eligibility determined for other sources of financial aid, including federal and state grants. 2. Read the Application & Solicitation Disclosure before applying for the SELF Loan. 3. You can either complete the SELF Loan counseling included in this packet or you can go online to complete it at 4. Complete the Borrower s Section of the SELF Loan Application & Promissory Note. If all information is not completed, it will be returned to you and processing will be delayed. 5. You must provide a credit worthy Co-signer, regardless of your age, marital status, or whether or not you are determined to be self-supporting for financial aid. Program rules require the Co-signer to be at least 24 years old or 18 years old if a sibling (i.e., a brother or sister) and either a U.S. citizen or a permanent resident with a valid Immigration and Naturalization Service (I.N.S.) Alien Registration Number. A credit-worthy Co-signer is one who has no account balances discharged through bankruptcy; no garnishments, attachments, foreclosure, repossession or suit; no more than $300 combined total in unsatisfied credit or unsatisfied payment obligations; or no more than five percent of credit bureau balances past due. Have your Co-signer complete the Co-signer s Section of the Application. This person must pass a credit check, and will be responsible with you for payment of your loan. 6. Complete the Self-certification Form. For information on your cost of attendance and estimated financial assistance please contact your school. This form must be returned with your application. 7. The Office of Higher Education will perform a credit check on your Co-signer, process the Application, and determine the amount of the loan to be made. If the loan is approved, a Loan Approval Disclosure Form will be sent to you. You must accept the loan through one of the methods listed on the form. 8. Return the following fully completed items to the Office of Higher Education by mail. Application & Promissory Note Application Self-Certification Counseling Acknowledgement Mailing address: Don't borrow more than you need. Remember, this isn't free money you need to pay interest while you are in school and then repay what you borrowed. Office of Higher Education P.O. Box St. Paul, MN Visit to check on the status of your loan. Notices to Borrower and Co-signer: There are two SELF Loan interest rate options to select from: Fixed Rate interest rate does not change during the term of the loan. Variable Rate interest rate is subject to change throughout the life of the loan. The Application & Promissory Note and Solicitation Disclosure explain how the variable interest rate is determined and when it may change. The Minnesota Office of Higher Education does not discriminate on the basis of disability in the admission or access to its program or activities. The SELF Loan Application can be made in available in an alternative format to people with disabilities upon request.

2 What Every Borrower and Co-signer Should Know 1. SELF Loans are not federal loans, and cannot be included in a federal loan consolidation. 2. Eligibility for repayment of SELF Loans under any student loan repayment program, such as a military program or AmeriCorps, is based on the criteria established by those programs for repayment of non-federal student loans. 3. If you are in active military service, you need to provide the servicer with a copy of your military orders in order to be eligible for any interest rate reductions or other benefits associated with your active military service. 4. If you selected the fixed rate option, the interest rate will not change after the terms of the disclosure have been accepted. The variable interest rate can change each calendar quarter (January, April, July and October) throughout the life of the loan. You must pay interest on the SELF Loan while in school. There are no guarantee, processing or application fees. 5. Eligibility is based on the school s cost of attendance, minus any other financial aid you have received or are expected to receive. 6. Borrow only what you need to pay for your education. Remember, you need to pay interest while you are in school and the balance of the loan later. The amount you may borrow depends on the type of program you are enrolled in. The minimum loan is $500. Short programs less than an academic year (typically eight or nine months or at least 900 clock hours): - Individual loans up to $3,500 with a cumulative maximum of $7,500 for all short programs. Academic year programs which are not bachelor s degrees, post-baccalaureate, or graduate: - Individual loans up to $7,500 with cumulative maximums of: Grade Level 1 $7,500 Grade Level 2 $15,000 Grade Level 3 $22,500 Bachelor s degree, post-baccalaureate, or graduate programs: - Individual loans up to $20,000 with cumulative maximums of: Grade Level 1 $20,000 Grade Level 2 $40,000 Grade Level 3 $60,000 Grade Level 4 $80,000 Grade Level 5 $100,000 Grade Level 6-9 $120, Not all postsecondary institutions are Eligible Schools with the SELF Program. An Eligible School is a school that has signed a contract to participate in the SELF Program. If you re-enroll or transfer to a postsecondary institution that is NOT an Eligible School, you will NOT qualify for In-School status for this loan. 8. There are no deferments. You must pay interest while in school. You will receive your first bill within 90 days of disbursement. Please refer to #3 of the SELF Loan Promissory Note Terms for specific requirements. 9. If you leave school or reduce your enrollment, funds cannot be disbursed to you even if you owe the school money. 10. SELF Loans are serviced by a Servicer. A Servicer schedules and disburses your loan, sends your bills, keeps track of your loan payments and your current loan status. You are required to notify the Servicer whenever your name, phone number, address, graduation date, or enrollment status changes. Paying is your responsibility. If it is time to make a payment and you have not received a bill, you still must pay. Notify the Servicer immediately if you are not getting your bills. See for phone numbers to contact the Servicer. For a copy of the SELF Servicing Appeals Process, write to the Minnesota Office of Higher Education. 11. If while in the In-School or Transition Periods you transfer schools, or pursue a graduate-level degree at another institution, you may be eligible to continue in the In-School Period as long as the Servicer is notified, your Transition Period has not ended, you have not entered a mandatory repayment period, and the new school is a member of the SELF Program. You may NOT have any remaining scheduled disbursements sent to the new school. Any remaining scheduled disbursements will be cancelled and you may apply for another loan at the new school. 12. If you miss a scheduled loan payment, you are delinquent. If you fail to meet any of the conditions of the promissory note, you may be in default. If you default, the following will happen: a) The loan may become immediately due and payable in full. b) The default will be reported to the credit bureaus. c) Your and your Co-signer s Minnesota tax refunds, rebates or lottery winnings will be intercepted and used to repay your debt. d) You and your Co-signer could be sued in court to pay your debt. If a judgment is obtained, you and your Cosigner could have your wages garnished. e) You will be responsible for any costs of collecting your debt, including all attorney s fees. f) Any disbursements not yet made will be cancelled, and you will not be allowed to borrow in the future. 13. If you find you need additional money after you submit your application, you may submit another SELF Loan application if (A) you request at least $500, (B) time remains to process the application, and (C) you have not already exceeded the borrowing limits.

3 Loan Interest Rate & Fees - Fixed Private Education Loan Application and Solicitation Disclosure Page 1 of 2 Minnesota Office of Higher Education PO Box St. Paul, MN The fixed interest rate is: 6.00% Your Starting Interest Rate (upon approval) The interest rate you pay is not dependent on your credit score or other factors. Your Interest Rate during the life of the loan Your rate is fixed. This means that your rate will not change over the life of the loan. The maximum interest rate for this loan is 6.00%. Loan Fees Late Charge: Up to $20 for payments not made within 15 days of the due date. Returned Payment Charge: up to $ Loan Cost Examples The total amount you will pay for this loan will vary depending upon when you start to repay it, the aggregate balance of your loans and your repayment period. This example provides estimates based upon the option available to you while enrolled in a participating SELF school at least half-time. Repayment Option (while enrolled in a participating SELF school at least half-time) PAY ONLY THE INTEREST Make interest payments but defer payments on the principal amount while enrolled in school. Amount Provided (amount provided directly to your school) Interest Rate (highest possible starting rate) $10, % Loan Term (how long you have to pay off the principal amount of your loan) 9 years starting after the 1-year Transition Period ends Total Paid over 14 years (4 years In-School, 1 year Transition and 9 years Repayment) (includes associated fees) $15, About this example This example is based on required quarterly interest payments during the In-School Period and monthly interest payments during a one-year Transition Period after the In-School Period ends. The nine-year Repayment Period begins after the one-year Transition Period ends. This example assumes you are in school for four years, have a one-year Transition Period before beginning the Repayment Period and you have up to 10 years (including the Transition Period) from when you leave school to repay the loan. You may have an option to select up to two more years of interest-only payments without extending your payment term. If balances on all your SELF Loans are $20,000 up to $40,000, you may have up to 15 years (including the Transition Period) after you leave school to repay the loans. If balances on all your SELF Loans are $40,000 or greater, you may have up to 20 years (including the Transition Period) after you leave school to repay the loans. These options may cause the interest you pay to be different than the example shown.

4 Private Education Loan Application and Solicitation Disclosure Page 2 of 2 Federal Loan Alternatives Loan Program PERKINS for Students STAFFORD for Students Current Interest Rates by Program Type 5.00% fixed 4.45% fixed Undergraduate Subsidized & Unsubsidized 6.0% fixed Graduate Unsubsidized You may qualify for Federal education loans. For additional information, contact your school s financial aid office or the Department of Education at: PLUS for Parents and Graduate/ Professional Students Next Steps 7.0% fixed 1. Find Out About Other Loan Options. Some schools have school-specific student loan benefits and terms not detailed on this form. Contact your school s financial aid office or visit the Department of Education s website at for more information about other loans. 2. To Apply for this Loan, Complete the Application and the Self-Certification Form. If you are approved for this loan, the loan terms will be available for 30 days. REFERENCE NOTES Fixed Interest Rate This loan has a fixed interest rate. Bankruptcy Limitations If you file for bankruptcy, you may still be required to pay back this loan. Prepayments There is no penalty for early repayment of the loan. Eligibility Criteria Borrower Enrolled at an eligible school at least half-time A Minnesota resident if attending a non-minnesota school Making satisfactory progress Not in default of any student loan or delinquent on any existing SELF Loan Co-Signer U.S. citizen or permanent resident At least 24 years old or 18 years old if a sibling of the borrower Credit worthy Repayment Options Your actual Repayment Period will be determined based on the aggregate loan amounts of your SELF Loans based on the criteria below: (a) Aggregate loan amounts of less than $20,000 have a maximum Repayment Period of 10 years after the In-School Period ends. (b) Aggregate loan amounts of $20,000 up to $40,000 have a maximum Repayment Period of 15 years after the In-School Period ends. (c) Aggregate loan balances of $40,000 or more have a maximum Repayment Period of 20 years after the In-School Period ends. Loans are required to enter principal repayment no later than nine years after the first disbursement. You may select to have up to two additional years of interest only payments if you have not entered a required Repayment Period; however, your maximum Repayment Period will not be extended. At the time you enter the Repayment Period, the payment amount of this loan may change if you currently or previously had other SELF Loans outstanding. During the Repayment Period, the minimum total monthly payment on your SELF Loan accounts will be at least $50. The minimum monthly payment will be larger if necessary to repay the loans within the Repayment Period. Your actual Finance Charge may be greater or less than the amount listed on this disclosure depending upon when your loan enters repayment, the aggregate loan amounts, the required minimum monthly payment, interest rate changes in your variable rate loans, and other factors. Refer to the SELF Loan Promissory Note Terms for additional terms and conditions.

5 Loan Interest Rate & Fees - Variable Private Education Loan Application and Solicitation Disclosure Page 1 of 2 Minnesota Office of Higher Education PO Box St. Paul, MN The starting interest rate for the current quarter is: 3.90% The current interest rate is available at Your interest may change quarterly and will vary with market conditions. Your Starting Interest Rate (upon approval) The starting interest rate you pay is not dependent on your credit score or other factors. All SELF V variable rate loans are charged the same interest rate. Your Interest Rate during the life of the loan Your rate is variable. This means that your rate could move lower or higher than the rate on this form. There is a limitation that the interest rate cannot increase or decrease more than 3% over any four consecutive calendar quarters. The variable rate is based upon the LIBOR Rate. There is no maximum interest rate; however, there is a limitation that the interest rate cannot increase or decrease more than 3% over any four consecutive calendar quarters. See the Reference Notes for more information on the variable interest rate. Loan Fees Late Charge: Up to $20 for payments not made within 15 days of the due date. Returned Payment Charge: up to $ Loan Cost Examples The total amount you will pay for this loan will vary depending upon when you start to repay it, the aggregate balance of your loans and your repayment period. This example provides estimates based upon the option available to you while enrolled in a participating SELF school at least half-time. Repayment Option (while enrolled in a participating SELF school at least half-time) PAY ONLY THE INTEREST Make interest payments but defer payments on the principal amount while enrolled in school. Amount Provided (amount provided directly to your school) Interest Rate (highest possible starting rate) $10, % Loan Term (how long you have to pay off the principal amount of your loan) 9 years starting after the 1-year Transition Period ends Total Paid over 14 years (4 years In-School, 1 year Transition and 9 years Repayment) (includes associated fees) $13, About this example This example is based on required quarterly interest payments during the In-School Period and monthly interest payments during a one-year Transition Period after the In-School Period ends. The nine-year Repayment Period begins after the one-year Transition Period ends. This example assumes you are in school for four years, have a one-year Transition Period before beginning the Repayment Period and you have up to 10 years (including the Transition Period) from when you leave school to repay the loan. You may have an option to select up to two more years of interest-only payments without extending your payment term. If balances on all your SELF Loans are $20,000 up to $40,000, you may have up to 15 years (including the Transition Period) after you leave school to repay the loans. If balances on all your SELF Loans are $40,000 or greater, you may have up to 20 years (including the Transition Period) after you leave school to repay the loans. These options may cause the interest you pay to be different than the example shown.

6 Federal Loan Alternatives Private Education Loan Application and Solicitation Disclosure Page 2 of 2 Loan Program PERKINS for Students STAFFORD for Students Current Interest Rates by Program Type 5.00% fixed 4.45% fixed Undergraduate Subsidized & Unsubsidized 6.0% fixed Graduate Unsubsidized You may qualify for Federal education loans. For additional information, contact your school s financial aid office or the Department of Education at: PLUS for Parents and Graduate/ Professional Students Next Steps 7.0% fixed 1. Find Out About Other Loan Options. Some schools have school-specific student loan benefits and terms not detailed on this form. Contact your school s financial aid office or visit the Department of Education s website at for more information about other loans. 2. To Apply for this Loan, Complete the Application and the Self-Certification Form. If you are approved for this loan, the loan terms will be available for 30 days (terms will not change during this period, except as permitted by law and the variable interest rate may change based on the market). REFERENCE NOTES Variable Interest Rate Your loan has a variable Interest Rate that is based on a publicly available index, the 3-Month LIBOR Rate. Your rate is calculated each quarter by adding the Margin to the Index. The Margin is determined by the Minnesota Office of Higher Education each quarter and may increase or decrease. If the LIBOR Rate and/or the Margin increases or decreases, the Interest Rate you pay may increase or decrease from the current rate. There is a limitation that the interest rate cannot increase or decrease more than 3% over any four consecutive calendar quarters. Bankruptcy Limitations If you file for bankruptcy, you may still be required to pay back this loan. Prepayments There is no penalty for early repayment of the loan. Eligibility Criteria Borrower Enrolled at an eligible school at least half-time A Minnesota resident if attending a non-minnesota school Making satisfactory progress Not in default of any student loan or delinquent on any existing SELF Loan Co-Signer U.S. citizen or permanent resident At least 24 years old or 18 years old if a sibling of the borrower Credit worthy Repayment Options Your actual Repayment Period will be determined based on the aggregate loan amounts of your SELF Loans based on the criteria below: (a) Aggregate loan amounts of less than $20,000 have a maximum Repayment Period of 10 years after the In-School Period ends. (b) Aggregate loan amounts of $20,000 up to $40,000 have a maximum Repayment Period of 15 years after the In-School Period ends. (c) Aggregate loan balances of $40,000 or more have a maximum Repayment Period of 20 years after the In-School Period ends. Loans are required to enter principal repayment no later than nine years after the first disbursement. You may select to have up to two additional years of interest only payments if you have not entered a required Repayment Period; however, your maximum Repayment Period will not be extended. At the time you enter the Repayment Period, the payment amount of this loan may change if you currently or previously had other SELF Loans outstanding. During the Repayment Period, the minimum total monthly payment on your SELF Loan accounts will be at least $50. The minimum monthly payment will be larger if necessary to repay the loans within the Repayment Period. Your actual Finance Charge may be greater or less than the amount listed on this disclosure depending upon when your loan enters repayment, the aggregate loan amounts, the required minimum monthly payment, interest rate changes in your variable rate loans, and other factors. Refer to the SELF Loan Promissory Note Terms for additional terms and conditions.

7 SELF Loan Counseling Let's Begin The Minnesota Office of Higher Education, a state agency, is the only lender for SELF Loans. The SELF Loan is not a federal loan, but rather a state loan, unique to Minnesota. Taking on student loan debt is a big responsibility. Make sure you fully understand your responsibilities before applying for the SELF Loan or any other student loan. Key Points You Need to Know: Before borrowing see if you qualify for federal or state grants. Federal loans may be more beneficial for you. Borrow only what you need. Remember, this isn't free money. You need to pay interest while you are in school and then repay what you borrowed. Co-signers are required to make payments if you don't. There are no deferments. Forbearance and repayment options are extremely limited. What Should I do Before Applying for the SELF Loan? Check Out Your Grant Options Finance your education with free money first. You don't have to repay grants, scholarships, or work-study. You are required to complete the Free Application for Federal Student Aid (FAFSA) to determine whether you qualify for federal or state grants unless you are a graduate student or attending a school that does not participate in federal or state grant programs. Check Out Your Federal Loan Options Before you apply for the SELF Loan make sure you look into any federal education loans at you may be eligible for. You should understand these benefits of federal loans: No interest payments required during school for subsidized federal loans Low fixed interest rates Deferments Forbearances Loan forgiveness Various repayment plans (including income-based) Many of these benefits are unavailable for the SELF Loan. Borrow Only What You Need Finally, borrow as a last resort and only borrow what you need. You don't have to borrow the maximum amount you are eligible for. Using savings and earnings can reduce the amount you need to borrow. What are the Costs for a SELF Loan? The SELF Loan is money that needs to be paid back to the lender, the Office of Higher Education. It's not a scholarship or grant. In addition to paying back the loan you also need to pay interest in order to use the money. Your interest rate will depend on whether you choose the fixed- or variable-rate SELF Loan. Once you select which type of interest rate you want you can't change your mind. As of April 1, 2018, the variable interest rate is 3.9%. The interest rate can change quarterly

8 (every three months). The interest rate can increase or decrease but will not change more than 3% during any 12-month period. More information about how the interest rate is calculated is available on our website. The fixed interest rate is 6.0% as of October 1, 2016, and won't change over the life of the loan. Deciding whether you want a fixed or variable interest rate depends on your desire to know what the rate will be over the life of the loan versus having a lower rate to start with. How much you borrow and when you anticipate repaying the loan can also influence your decision. Check out our Calculator on our website to estimate your in-school interest payment and your payments after school. What are the Repayment Requirements for the SELF Loan? The SELF Loan was designed to make repayment manageable by dividing it into three periods: In-School Period Transition Period Repayment Period You must start repaying your SELF Loan no later than nine years from when you received the money even if you are still in school or a Transition Period. The In-School Period In the In-School Period, you are required to make quarterly interest payments. The In-School Period begins when you receive the money and continues as long as you're enrolled at least half-time in a participating school and aren't in a mandatory Repayment Period. You can stay in the In-School status if you transfer to another school as long as the new school participates in the SELF Program. View a list of participating SELF schools on our website. If you return to a SELF member school at least half-time within three years after you leave school or within three years after your enrollment drops below half-time, your loan may be returned to the In-School status. You will need to contact the loan servicer, Firstmark Services to see if you are able to return to In-School status. The Transition Period In the Transition Period you are required to make monthly interest payments. The 12-month transition period begins: upon graduation, if your enrollment drops to below half-time, or if you transfer to a non-self school. The Repayment Period In the Repayment Period you are required to make monthly payments of principal and interest. The Repayment Period starts at the end of the 12-month Transition Period or nine years after you took out the loan whichever is earlier. You have two repayment options: The Standard Plan requires monthly payment of principal and interest starting 13 months after you leave school or attend less than half-time. The Extended-Interest Plan allows you to continue with two more years of monthly interest payments before starting to repay the amount you borrowed. While the Extended-Interest Plan extends the transition period, it shortens the repayment period by two years. This means your payments may be larger when you start repaying your loan.

9 How long you have to pay off the loan depends on how much you borrow from the SELF program. You have up to 10 years to repay your loan if you borrowed less than $20,000. If you borrowed between $20,000 and $40,000, you have 15 years. For $40,000 or more, 20 years. The minimum payment is $50 a month. What do I Need to Know about Repaying the SELF Loan? You are responsible for repaying your SELF Loan even if you don't complete your educational program, aren't satisfied with your education, or are unable to find a job. Your co-signer is responsible for making payments if you are unable to do so or do not make them. You need to pay interest every three months while you are in school starting within 90 days from when you receive the money. You must start repaying your SELF Loan no later than nine years from when you received the money. There are no grace periods or deferment options. SELF Loans cannot be included in a federal government loan consolidation. There is no penalty for early payment. You and your co-signer will have consequences if the loan is past due or defaults. There is no co-signer release or changing of co-signers. What happens if I change schools or enroll in a graduate program? If you transfer to another school or go on to graduate school, you can make interest only payments if: you transfer within three years from when you leave school or attend less than half-time; have not entered a required repayment period; you are enrolled at least half-time; and the new school is eligible. View a list of schools participating in the SELF program on our website. Can I capitalize my SELF interest instead of making quarterly payments? The SELF Loan does not allow you to add your in-school interest onto your loan balance like some other student loan programs do. There are benefits of paying interest while in school: the overall amount of interest you pay will be less and quarterly bills keep you aware of your loan balance and the interest cost of your loan. Who is the Loan Servicer for SELF Loans? Firstmark Services is the loan servicer for the SELF Loan. Firstmark will send money to your school, send you bills, record your payments, and contact you and your co-signer if payments are not made. You and your co-signer must contact Firstmark Services for any name, mailing address, address, or phone number changes.

10 What Happens If I Don't Make My SELF Loan Payments When I am in School? Any scheduled loan disbursements to your school will be cancelled if you aren't making your required SELF Loan payments. You may not be able to register for classes if you have outstanding bills to the school as a result of your disbursement being cancelled. Your loan can default while you are in school if you don't make your payments. If you default on your SELF Loan, your Minnesota State Grant funds can be withheld. What Happens If I Default? If you or your co-signer are delinquent on any SELF Loan payment beyond 120 days or if you have failed to meet any of the other conditions, the loan will default. Filing for bankruptcy can put you in default. In most cases, student loans are not discharged by filing bankruptcy. If your loan should default, the Office of Higher Education can take the following actions: Report the default to the credit bureau Take money out of your paycheck Take money out of your bank account Get a court judgment against you Take your tax refund Turn your loan over to a collection agency with collection fees added to the balance Hold or cancel your Minnesota State Grant Defaulting on your SELF Loan can make it difficult for you or your co-signer to borrow money to purchase a car, a home, or even obtain a credit card. Many employers look at credit reports to evaluate the integrity of perspective employees. In order to make sure you understand the key points please acknowledge you have read the above information by completing the signature page included in this packet and return it to the Office of Higher Education.

11 How to Complete the SELF Loan Application and Promissory Note Borrower s (Student's) Section: 1. Print your last name, first name, middle initial, and suffix (Sr., Jr., III, etc.), if applicable. Use full, legal name and no nicknames. Print your Billing Address. This is an address considered to be reliable and consistent for billing purposes. Include street name and number, apartment number, RFD, General Delivery or P.O. Box, city, state, and zip code that is part of the mailing address. Note: Dormitory and other such temporary addresses, as well as addresses outside the United States and its possessions, are NOT acceptable. 2. Print your Social Security number. Note: Read the Privacy Act Notice to the Borrowers and Co-signers printed on the back of the Application which gives information about disclosing a Social Security number. 3. Using two-digit numbers, print your birth date. (For example, January 6, 1996 would be written 01/06/96.) 4. Print your area code and telephone number 5. Print the two-digit abbreviation for the state where you are a permanent resident. Print the year you started living in that state. Note: To use a SELF Loan at an eligible school outside the state of Minnesota, you must be a Minnesota resident. 6. Print the begin and end dates of the loan period you want the loan to cover. (For example, September 5, 2016 to June 25, 2017 would be written 09/05/16 06/25/17.) 7. Print the total loan amount requested. The minimum SELF Loan is $500. Refer to #6 under What Every Borrower and Co-signer Should Know for SELF Loan limits. 8. Select the interest rate option you would like only select one option. Note: You cannot change the SELF Loan Amount Requested or the Interest Rate selected. If you need to change either one of the boxes, a new application must be completed. 9. Print your driver s license number, including the two-letter abbreviation for the state of issuance. If no driver s license, enter N/A. 10. Please provide your address. 11. Sign your legal name, including first name, middle initial, last name, and suffix, if applicable. By signing, you acknowledge that you have read, understand, and agree to the provisions in the SELF Loan Promissory Note Terms, Borrower s Certification, and the Privacy Act Notice to Borrowers and Co-signers and you agree to repay the loan in full. Note: If you fail to sign and date the form, your Application will be returned to you and processing will be delayed. 14. Print the name of the school you are attending. 15. Print the USDE Vendor Number of your school. If you do not know the number you can contact your school or locate it at Print your anticipated graduation date for your degree or program. (For example, June 25, 2018 would be written 06/25/18.)

12 Notice to Co-signer: Co-signer s Section: Please do not co-sign this loan if you are not willing or able to repay this debt in the event that the Borrower does not. 12a. Print the Co-signer s last name, first name, middle initial, and suffix (Sr., Jr., III, etc.), if applicable. Use full, legal name and no nicknames. Print the Co-signer s permanent address. Include street name and number, any apartment number, RFD, General Delivery or P.O. Box, city, state, and zip code that is part of the mailing address. The Co-signer s address must be located in the U.S. or its possessions. 12b. Print the Co-signer s Social Security number. Note: Read the Privacy Act Notice to Borrowers and Co-signers printed on the back of the Application which gives information about disclosing a Social Security number. 12c. Using two-digit numbers, print the Co-signer s birth date. For example, February 10, 1970 would be written 02/10/70. 12d. Print area code and telephone number of the Co-signer. 12e. Indicate if the Co-signer is a U.S. citizen or permanent resident. If a permanent resident, please print Immigration and Naturalization Service (I.N.S.) Alien Registration Number. 12f. Indicate the Co-signer s relationship to the Borrower. 12g. Please provide your address. 13. Locate a Notary Public. The Notary will ask to see identification. Co-signer must sign and date the Application only in the presence of the Notary. By signing, you acknowledge that you have read, understand, and agree to the provisions in the SELF Loan Promissory Note Terms, Co-signer s Certification, and the Privacy Act Notice to Borrowers and Co-signers and that the Co-signer agrees to repay the loan in full if the Borrower does not. If the Co-signer makes statements or represents himself/ herself inaccurately on this Application & Promissory Note, the Co-signer is subject to prosecution and, if convicted, possible penalties under state or federal law may include a fine or imprisonment.

13 Application & Promissory Note Phase V Please read all the information with this Application & Promissory Note before completing. If all information is not completed, the application will be returned to you and processing will be delayed. Office Use Only: Total Amount Approved: Approved By: Approval Date: Date Received: 1. Borrower s Information (Please print clearly in ink): Last First Middle Initial Suffix, if applicable Billing Address Billing Address City State Zip 9. Borrower s Driver s License Number: State: 2. Social Security Number 3. Birth Date (Month, Day, Year): / / 5. State of Residence: Since (year): 7. SELF Loan Amount Requested: $ 10. Address: 4. Telephone with Area Code: ( ) - 6. Loan Period begin and end: / / / / 8. Interest Rate Selected: Fixed Variable 11. Promise to Pay: I understand this is a Promissory Note, or contract to pay, and a Loan Application. I have read, understand, and agree to the SELF Loan Promissory Note Terms, the Borrower s Certification and the Privacy Act Notice to Borrowers and Co-signers. I promise to pay to your order the amount stated in box #7, or any smaller amount loaned to me on this Note, plus interest and late charges, in accordance with the SELF Loan Promissory Note Terms. In the event of default I agree to reimburse to you all fees paid or payable by you to any collection agency or entity, which may be based on a percentage at a maximum of 39% of the debt, and all costs and expenses including reasonable attorneys' fees, process service fees, garnishment fees, or other fees that you may incur in any collection efforts or the enforcement of judgment, whether judgment is obtained against borrower and/or cosigner. Signature of Borrower Date 12a. Co-signer s Information (Please print clearly in ink): Last First Middle Initial Suffix, if applicable Billing Address Billing Address 12b. Social Security Number: 12c. Birth Date (Month, Day, Year): 12d. Telephone with Area Code: ( ) - 12f. Relationship to the Borrower (Check one): / / 12e. U.S. Citizen Perm. Resident & Number: Parent Sibling Grandparent Legal Guardian Spouse Other City State Zip Co-signer s Address: 13. Promise to Pay: I understand this is a Promissory Note, or contract to pay, and a Loan Application. I have read, understand, and agree to the SELF Loan Promissory Note Terms, the Co-signer's Certification and the Privacy Act Notice to Borrowers and Co-signers. I promise to pay to your order the amount stated in box #7, or any smaller amount loaned to the Borrower on this Note, plus interest and late charges, in accordance with the SELF Loan Promissory Note Terms. In the event of default I agree to reimburse to you all fees paid or payable by you to any collection agency or entity, which may be based on a percentage at a maximum of 39% of the debt, and all costs and expenses including reasonable attorneys' fees, process service fees, garnishment fees, or other fees that you may incur in any collection efforts or the enforcement of judgment, whether judgment is obtained against borrower and/or co-signer. Co-signer signature must be Signature of Co-signer Signature of Notary Public done in front of a Notary. [Notary Stamp or Seal] Date Commission Expires Notary s Address, City, State and Zip 14. Name of School: 15. USDE Vendor Number: 16. Anticipated Graduation Date (MM, DD, YY): / / HI (update 07/2016) Authoritative Copy Send completed form to: For Information: Minnesota Office of Higher Education (651) or (800) P.O. Box For the Hearing Impaired: St. Paul, MN TTY Relay: (800)

14 SELF Loan Promissory Note Terms: For purposes of this promissory note I, me or my refers to the borrower and co-signer; you, your or lender refers to the Minnesota Office of Higher Education and/or its servicer, agent, or assign. 1. Promise to Pay: The borrower and the co-signer; jointly and severally promise to pay to the lender the amount requested or any smaller amount disbursed on this note, plus interest and late charges, and in the event of default, all collection fees and all attorney's fees, as described in these terms and conditions. 2. Interest Rate: Once I have selected the Fixed Rate or Variable Rate the designation cannot be changed during the life of the loan. If I selected Fixed Rate, I will pay the lender interest on the unpaid principal balance of the loan at an annual rate equal to the fixed rate that I agreed to when I accepted the loan. If I selected Variable Rate, I will pay the lender interest on the unpaid principal balance of the loan at an annual rate equal to the Margin plus the Index Rate. a. Index Rate: The Index Rate in any calendar quarter is the arithmetic average rounded to the nearest tenth of one percent of the three-month London Interbank Offered Rates (LIBOR) rate during the calendar quarter immediately preceding the interest rate adjustment date. The Index Rate may change on January 1, April 1, July 1 and October 1 of each year. b. Margin: The Margin is an annual percentage rate fixed by the lender. The lender may increase or decrease the Margin. The Margin may change on January 1, April 1, July 1 and October 1 of each year. c. Effect of Increase or Decrease in Index Rate or Margin: If the Index Rate or the Margin increases or decreases, the interest rate on the loan may increase or decrease. Any change in the interest rate will take place automatically on the same day as the change in the Index Rate or the Margin without notice to me. The interest rate on the loan will not increase or decrease more than three percentage points over any four consecutive calendar quarters. d. Information: I may find out what the Margin or Index Rate is by contacting the lender or checking the SELF website. 3. Payment: a. Phase V SELF Loans will enter the Repayment Period no later than nine years after the first disbursement date on the loan, regardless of any In-School Period or Transition Period that would otherwise apply. b. In-School Period: Unless the loan has entered a mandatory Repayment Period as provided in 3.a. above, the period during which the borrower is an In-School Student is the In-School Period. During the In-School Period, I will pay interest accrued on the loan. I will make payments every three months. The first payment will be due approximately three months after the date of the first disbursement. When the borrower stops being an In-School Student, I will also pay interest accrued since the last quarterly interest payment. If the principal balance on the SELF Loan is less than $50, I will be billed for the entire balance. c. Transition Period: Unless the loan has entered a mandatory Repayment Period as provided in 3.a. above, the Transition Period for this note begins the month after the borrower stops being an In-School Student. It continues for up to 12 months, unless the borrower signs an Extended Interest Form to continue it for up to an additional 24 months (making a maximum Transition Period of 36 months). During the Transition Period, I will pay accrued interest on the loan each month. If the principal balance is less than $50, I will be billed for the entire balance. d. Repayment Period: The Repayment Period begins the earlier of nine years after the first disbursement date on the loan or at the end of the Transition Period. During the Repayment Period, I will pay monthly installments of principal and interest on the loan. Before the first payment of principal is due, the lender will inform me in writing of the repayment terms for the loan. I will repay the loan on the terms described in this note. (i) I will repay the loan in monthly installments of principal plus accrued interest. (ii) The maximum repayment period for Phase V SELF Loans is based on the aggregate principal loan balances of all the borrower s SELF Loans. (a) Aggregate loan balances of less than $20,000 have a maximum Repayment Period of 10 years after the In-School Period ends. (b) Aggregate loan balances of $20,000 up to $40,000 have a maximum Repayment Period of 15 years after the In-School Period ends. (c) Aggregate loan balances of $40,000 or more have a maximum Repayment Period of 20 years after the In-School Period ends. (iii) During the Repayment Period, the minimum monthly payment on the borrower s SELF Loan accounts will be at least $50. The minimum monthly payment will be larger if necessary to repay the loans within the applicable Repayment Period as described in Section 3.d (ii). (iv) Before the first principal payment, the lender will calculate the amount of principal I will pay each month. Under either a Fixed or Variable Rate loan the lender will assume that the interest rate on the loan at the time of the calculations will not change. The lender will then figure what the principal payments on the loan would be each month if I repaid the loan in equal monthly installments including principal and interest at that rate. To get the monthly payment after the initial calculation, the lender will add interest accrued at the actual rate. e. The borrower is an In-School Student if the borrower: (i) is enrolled in an Eligible School located in Minnesota or is a Minnesota resident enrolled in an Eligible School located outside Minnesota, and (ii) is enrolled in a program leading to a certificate or undergraduate or graduate degree, and (iii) is enrolled on at least a half-time basis, and (iv) has been enrolled as described above in (i), (ii) and (iii), since the first loan disbursement under this note, or if not, the borrower again becomes an In-School Student before the required Repayment Period for this loan begins. After the maximum Transition Period ends or after a required Repayment Period has started for this loan, the loan cannot return to In-School status even upon re-enrollment. f. Payment Date: The lender will provide the borrower a bill either by mail or, with the borrower's consent, electronically. I will make the payment on or before the payment date stated in the bill. The lender's failure to send or my failure to receive a bill does not eliminate or delay my obligation to pay. 4. Co-signer Liability: The co-signer is responsible for all the obligations owed to the lender under this note, including the obligations to pay the principal, interest, collection fees and attorneys' fees on the loan and give the lender notice of co-signer address and name changes. The lender may, at the lender s option, notify the co-signer if the borrower is delinquent in payment, in default, or in bankruptcy. The lender is not required to send the co-signer copies of the bills the lender sends the borrower for payments due on the loan. The co-signer waives any defenses the co-signer may have to payment of this note except payment in full. The co-signer consents to the personal jurisdiction of the courts of Minnesota in any lawsuit involving this note. Any lawsuit involving this promissory note may be venued in Ramsey County, State of Minnesota. No substitution of co-signers is permitted. The lender may, at the lender s option, notify the borrower and the school if the co-signer is delinquent in payment, in default, or in bankruptcy. The lender may, at the lender s option, pursue the co-signer for payment of the loan. 5. Late Charge: If a payment is not made within 15 days after it is due, I may be charged a late fee not exceeding $20 for each late payment. 6. Pending Disbursements: If I am delinquent in payment on any SELF Loan, my pending disbursements may be withheld until payment is current or my disbursements may be permanently cancelled. 7. Cancellation: Neither the borrower nor the co-signer will be required to repay my loan if the borrower dies or becomes totally and permanently disabled after the loan is fully disbursed. Cancellation is in accordance with Minnesota Administrative Rules Cancellation is effective upon the lender s receipt and written approval of acceptable documentation. However, if the co-signer dies or becomes totally and permanently disabled after the loan is fully disbursed, the borrower will still have to repay this loan. 8. Prepayment: I may prepay all or part of the loan at any time without penalty. If I prepay part of the principal balance of the loan, I must continue to make all scheduled payments until the loan is fully paid 9. Application of Payments: You will apply payments first to collection fees, late fees, accrued interest and any other finance charges, then to other amounts I owe you, and last to the unpaid principal balance. I also consent to payment being made by either or both borrower and co-signer and authorize all payments thereby. 10. Defaults: I may be in default if I do not make any payment when due; make any false or misleading representation in obtaining any loan; use the loan for other than the cost of attending an Eligible School; fail to notify you when the borrower stops being an In- School Student; fail to perform any other provision of this note; default on any other loan I owe you; or file a petition in bankruptcy. 11. Fees and Costs: I agree to reimburse to you the fees, paid or payable by you, to any collection agency or entity, which may be based on a percentage at a maximum of 39% of the debt, and all costs and expenses, including reasonable attorneys' fees, process service fees, garnishment fees, or other fees that you may incur in any collection efforts or the enforcement of judgment, whether judgment is obtained against borrower and/or co-signer. 12. Remedies: If I am in default, the lender has several remedies. The lender may refuse to disburse additional loan funds. The lender may require me to repay immediately all amounts I owe the lender on this note or on any other SELF Loan. The lender may place my account with a collection agency, and the lender may withhold Minnesota State income tax refunds, State Lottery winnings, rent credits, and/or property tax credits or special refunds or rebates. The lender may also sue me for repayment of my loan. If the borrower is an In-School Student when I fail to pay, the lender may add to the principal balance of the loan up to 180 days unpaid interest accrued on the loan. The lender does not have to give me any notice of the choice of remedy. The lender may use any or all of the lender s remedies. The lender s acceptance of late or partial payments does not excuse my default or waive the lender s right to use any or all remedies, including accelerating payment of all amounts I owe the lender on this note or on any other SELF Loan. 13. Notice of Changes: I will notify the lender immediately of any change in my permanent address, phone number, my name or when the borrower stops being an In-School Student. 14. Governing Law: This note is governed by the laws of Minnesota. It is also covered by the lender s Rules which are available at the SELF website. I consent to the personal jurisdiction of the courts of Minnesota in any lawsuit involving this note. Any lawsuit involving this promissory note may be venued in Ramsey County, State of Minnesota. 15. Assignment: I may not give my rights or responsibilities under this note to anyone else. The lender may, however, transfer the lender s rights and responsibilities under this note to another entity. When the lender tells me, I will be required to make payments on this note to that entity. 16. Execution: The application and promissory note may be executed in one or more counterparts. All of the counterparts together will be the same note and will be legally enforceable. If original promissory note is not available, a copy shall hold the same effect as the original. 17. Servicing: In order for the lender to service the account or to collect any amount I may owe, I agree that the lender, servicer, collection agency or other representative of the lender may from time to time make calls and send s and text messages to me, using prerecorded/artificial voice messages and/or through the use of an automated dialing or sending device, at any telephone number or personal electronic device address associated with me or my loan, including telephone numbers or device addresses that could result in charges to me. Borrower s Certification: I, the borrower, declare under penalty of perjury under the laws of the United States of America and the State of Minnesota that the following is true and correct. I certify that the information I have provided is true, complete and correct to the best of my knowledge and belief and is given in good faith. I authorize you to verify the information I have provided through whatever sources may be necessary. All information obtained from me or any third party source may be used for collection purposes. I understand that you will either electronically transmit funds to the Eligible School on my behalf or issue the Eligible School a master check or a check made jointly payable to me and my school. I authorize my school to pay to you any refund that may be due to me, up to the amount of this loan. I certify that the proceeds of any loan made as a result of this application will be used for educational purposes. I further certify that I have read the information included with this application and that I understand my responsibilities. I give my permission to you, your loan servicer, your attorney, your collection agency, and to any financial institution or secondary market to whom you might sell my SELF Loan, to disclose identifying information about me and my SELF Loan to the consumer credit reporting agencies with whom you, your loan servicer or your collection agency have agreements, as provided in Minnesota Statutes Section 136A.162. Identifying information will consist of my borrower identification number, the type of account, the date the account was opened, the outstanding account balance, the dollar amount past due, the number of payments past due, the number of late payments in the last 12 months, the fact that my co-signer and I have responsibility for the account, and any applicable credit reporting agency codes and remarks indicating the status of the account. I give you permission to report the above information throughout the life of the loan account. I authorize you, your loan servicer, or your collection agency to check my credit and to answer questions about my credit experience with you. I authorize the Minnesota Office of Higher Education and its servicer to provide information to the Eligible School or any school to which I seek application or have been admitted, regarding this SELF Loan, any SELF Loans already outstanding, or any other SELF Loans for which I may apply. Co-signer s Certification: I, the co-signer, declare under penalty of perjury under the laws of the United States of America and the State of Minnesota that the information I have provided is true, complete, and correct to the best of my knowledge and belief. I authorize you to verify the information I have provided through whatever sources may be necessary. All information obtained from me or any third party source may be used for collection purposes. I authorize you, your loan servicer, your attorney and your collection agency to check my credit and to answer questions about my credit experience with you. I give my permission to you, your loan servicer, your attorney, your collection agency, and to any financial institution or secondary market to whom you might sell my SELF Loan, to disclose identifying information about me and my SELF Loan to the consumer credit reporting agencies with whom you, your loan servicer, or your collection agency have agreements, as provided in Minnesota Statutes Section 136A.162. The identifying information will be the same as that described in the Borrower s Certification. I give you permission to report the above information throughout the life of my loan accounts. Privacy Act Notice to Borrowers and Co-signers: Section 7 of the Privacy Act (found at 5 U.S.C. 552a note (Disclosure of Social Security Number)) (2015) provides that: It shall be unlawful for any Federal, State or local government agency to deny to any individual any right, benefit, or privilege provided by law because of such individual s refusal to disclose his social security account number. Sec. 7(a)(1). The Social Security number will be used to verify my identity, and as an identifier of my file in order to accurately record necessary data. As an identifier, the Social Security number is used in the SELF Program for such purposes as determining my eligibility for the program, and processing loan disbursements and payments. Although disclosure of my Social Security number is not legally required, failure to disclose it may cause delay in processing of the initial application and of subsequent information I may submit. Pursuant to Minnesota Statutes, Sec , subd. 2 (2015), I am hereby informed that the information supplied in this application may be used as follows: (1) in the processing and verification of the data supplied to determine my eligibility for this program; (2) for future collection and servicing of the loan; (3) for compilation and analysis of summary data relative to this program; and (4) for dissemination of information to the school. The above uses of information apply to information provided by or relating to the borrower and co-signer. The school will be notified if the borrower or co-signer is not eligible for the loan and the reason for ineligibility. I am not required to provide the information supplied in this application. Failure to submit requested data may prevent further processing of the application. The information supplied in this application may be shared with other public and private individuals and entities in order to use the information for the purposes specified above. As part of the electronic application process s containing the borrower and co-signer names may be sent to borrowers, co-signers and schools.

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